Tobias-Machado Marcos, Hidaka Alexandre Kiyoshi, Sato Leticia Lumy Kanawa, Silva Igor Nunes, Mattos Pablo Aloisio Lima, Pompeo Antonio Carlos Lima
Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, São Paulo, Brasil.
Int Braz J Urol. 2017 May-Jun;43(3):566. doi: 10.1590/S1677-5538.IBJU.2015.0091.
Pelvic Schwannoma is an extremely rare event. Laparoscopic approach for radical resection on pelvic region already has been described in the literature. However, with better image quality provided by optic in the laparoscopy we can assure an improvement in this kind of approach for tumor resection.
Our goal is to describe and evaluate the results of one laparoscopic resection of presacral and obturator fossa tumor.
We present a case of a 60-year-old man with progressive congestion in the right inferior member and CT scan revealing a mass with miscellaneous content located behind of the right iliac vessels and right obturator nerve. Exploratory transperitoneal laparoscopy was indicated. During laparoscopy it was possible to see the mass between the spermatic cord and external iliac artery. We made the identification and preservation of iliac vessels and obturator nerve. Resection of the tumor was performed carefully, allowing the safe removal of the specimen with complete preservation of the iliac vessels and obturator nerve.
Mean operative time of 150 minutes. No perioperative complications occurred. Two days of hospital stay. Posterior histopathological exam confirmed that the mass was a Schwannoma.
The maximization of the image in the laparoscopic surgery offers dexterity and capacity of dissection required for complex mass dissection on pelvic region.
盆腔神经鞘瘤极为罕见。文献中已描述了腹腔镜下对盆腔区域进行根治性切除的方法。然而,随着腹腔镜光学系统提供更好的图像质量,我们可以确保这种肿瘤切除方法得到改进。
我们的目标是描述并评估一例腹腔镜下骶前和闭孔窝肿瘤切除术的结果。
我们报告一例60岁男性患者,其右下肢进行性充血,CT扫描显示在右髂血管和右闭孔神经后方有一个含有多种成分的肿块。遂行 exploratory 经腹腹腔镜检查。在腹腔镜检查过程中,可以看到肿块位于精索和髂外动脉之间。我们识别并保留了髂血管和闭孔神经。仔细切除肿瘤,安全取出标本,同时完全保留了髂血管和闭孔神经。
平均手术时间为150分钟。未发生围手术期并发症。住院两天。术后组织病理学检查证实肿块为神经鞘瘤。
腹腔镜手术中图像的最大化提供了盆腔区域复杂肿块解剖所需的灵活性和解剖能力。 (注:“exploratory”此处可能有误,推测可能是“exploratory laparoscopy”即“探查性腹腔镜检查”,按正确意思翻译会使译文更通顺,但按要求未做修改)